Diagnostic Studies
- Endoscopy
- Primary tool for diagnosing source of upper GI bleeding
- Before performing
- Lavage may be needed for clearer view
- NG or orogastric tube placed, and room-temperature water or saline used
- Do not advance tube against resistance
- Lavage may be needed for clearer view
- Stomach contents aspirated through a large-bore (Ewald) tube to remove clots
- Angiography
- Used to diagnose only when endoscopy cannot be done
- Invasive procedure
- May not be appropriate for high-risk or unstable patient
- Catheter placed into left gastric or superior mesenteric artery until site of bleeding is discovered
- Laboratory studies
- Complete blood cell count (CBC)
- Blood urea nitrogen (BUN)
- Serum electrolytes
- Prothrombin time, partial thromboplastin time
- Liver enzyme measurements
- Laboratory tests
- ABG measurements
- Typing/cross matching for possible blood transfusions
- Test vomitus/ stools for presence of gross and occult blood
